109 articles - From Friday Jun 30 2023 to Friday Jul 07 2023
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Hepatology |
| J Hepatol |
EASL Clinical Practice Guidelines on the management of liver diseases in pregnancy. Whether related to pregnancy or pre-existing, liver diseases in pregnancy are associated with a significant risk of maternal and fetal morbidity and mortality. Thus, the European Association for the Study of Liver Disease invited a panel of experts to develop clinical practice guidelines aimed at providing recommendations, based on the best available evidence, for the management of liver disease in pregnancy for hepatologists, gastroenterologists, obstetric physicians, general physicians, obstetricians, specialists in training and other healthcare professionals who provide care for this patient population. |
meta-analyses and systematic reviews
| Gastrointest Endosc |
Adverse Events with Endoscopic Ultrasound-guided Biliary Drainage: A Systematic Review and Meta-analysis. Despite a high clinical success, EUS-BD may be associated with AE in one-seventh of the cases. However, major AE and mortality incidence remains less than 1%, which is reassuring. |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
Detection of changes in regional colonic fermentation in response to supplementing a low FODMAP diet with dietary fibres by hydrogen concentrations, but not by luminal pH. A modest increase in fermentable plus poorly fermented fibres had minor effects on faecal measures of fermentation, despite increases in plasma SCFA and abundance of fermentative bacteria, but the gas-sensing capsule, not pH-sensing capsule, detected the anticipated propagation of fermentation distally in the colon. The gas-sensing capsule technology provides unique insights into localisation of colonic fermentation. |
Effects of social determinants of health on mortality and incident liver-related events and cardiovascular disease in steatotic liver disease. Neighbourhood-level SDOH are associated with mortality, incidence of LREs and incident CVD in patients with steatotic liver disease. Interventions aimed at disadvantaged neighbourhoods may improve clinical outcomes. |
| Am J Gastroenterol |
Anastomotic configuration and temporary diverting ileostomy do not increase risk for anastomotic stricture in postoperative Crohn's disease. Anastomotic configuration, temporary diversion, and ileal CD recurrence do not increase risk for AS. Early detection and intervention for AS may help prevent progression to repeat ICR. |
Effect of three-dimensional imaging device on polyp and adenoma detection during colonoscopy: a randomized controlled trial. The 3D imaging device could improve overall PDR and ADR during colonoscopy, particularly in midlevel and junior endoscopists. Trial number: ChiCTR1900025000. |
Medication-wide study: Exploring medication use ten years prior to a diagnosis of inflammatory bowel disease. When analyzing therapeutic subgroups of medication, the CD population exhibited 2.7, 2.3, 1.9, and 1.9 times more users of immunosuppressants, antianemic preparations, analgesics, and psycholeptics than the matched population ten years prior to diagnosis (p-value <0.0001). Our findings demonstrate universally increased medication use years before IBD, especially CD, and indicates multiorgan involvement in IBD. |
Post-Endoscopy Care for Patients Presenting with Esophageal Food Bolus Impaction: A Population-Based Multicenter Cohort Study. One quarter of patients presenting with an FBI do not receive appropriate post-endoscopy care. This is strongly associated with failure to identify a potential underlying pathology at index presentation. |
Preoperative Risk Factors for Adverse Events in Adults Undergoing Bowel Resection for Inflammatory Bowel Disease: 15-Year Assessment of ACS-NSQIP. Preoperative factors contributing to the risk of an adverse surgical outcome are similar between younger and older individuals with IBD, and include elements such as malnutrition and functional status. Incorporating these measures into surgical decision-making can reduce surgical delays in older individuals at low-risk and help target interventions in those at high risk, transforming care for thousands of older adults with IBD. |
| Clin Gastroenterol Hepatol |
A Randomized Parallel-Group Study of Digital Gut-Directed Hypnotherapy vs Muscle Relaxation for Irritable Bowel Syndrome. Treatment with a digital GDH program led to an improvement in abdominal pain and stool symptoms in patients with IBS, supporting a role for this intervention as part of integrated care for IBS. |
Delayed Ustekinumab Responders in Ulcerative Colitis Have Greater Inflammatory Burden but Similar Outcomes as Early Responders. Compared with early ustekinumab responders, delayed responders had greater inflammatory burden at baseline. Early and delayed responders have similar one-year outcomes. Biomarker decline observed in delayed responders can help differentiate them from non-responders. |
Development and Validation of the NAFLD Familial Risk Score to Detect Advanced Fibrosis: a Prospective, Multicenter Study. The NAFLD Familial Risk Score is a simple and accurate clinical tool to identify advanced fibrosis in first-degree relatives. These data may have implications for surveillance in NAFLD. |
Evolution of symptoms after ustekinumab induction therapy in patients with Crohn's disease. Ustekinumab induction provided symptom relief by day 1 post-infusion. Following ustekinumab infusion and a SC 90 mg injection, clinical outcomes continued to increase through week 16 and up to week 44. Regardless of week-8 clinical status or ustekinumab pharmacokinetics, patients should receive additional treatment at week 8. |
Risk Stratification Model for Hepatocellular Cancer in Patients With Cirrhosis. The risk index, including objective and routinely available risk factors, can differentiate patients with cirrhosis who will develop HCC and help guide discussions regarding HCC surveillance and prevention. Future studies are needed for additional external validation and refinement of risk stratification. |
| Endosc Int Open |
Endoscopic closure versus surgical revision in the management of gastro-gastric fistula following Roux-en-Y gastric bypass. Endoscopic GGF treatment produces greater improvement in abdominal pain and fewer overall and serious treatment-related AEs. However, surgical revision appears to yield greater weight loss. |
| Endoscopy |
Assisted documentation as new focus for artificial intelligence in endoscopy: The precedent of reliable withdrawal time and image reporting. Our system calculates withdrawal time, provides an image report, and is real-time-ready. After further validation, the system may improve standardized reporting while decreasing workload caused by routine documentation. |
EUS-guided gastroenterostomy with lumen-apposing metal stents: a retrospective, multicentric comparison of wireless and over-the-wire techniques. The WEST has a higher technical success and less AEs, with a clinical success comparable to the DTOG. Therefore, the WEST technique (with an oro-intestinal drain) should be preferred to perform EUS-GE. |
| Gastroenterology |
Prevalence of liver steatosis and fibrosis in the general population and various high-risk populations: a nationwide study with 5.7 million adults in China. A substantial burden of liver steatosis and fibrosis was found in China. Our study provides evidence for shaping future pathways for screening and risk stratification of liver steatosis and fibrosis in the general population. The findings of this study highlight that fatty liver and liver fibrosis should be included in disease management programs as targets for screening and regular monitoring in high-risk populations, especially in those with diabetes. |
Psychological processes, not physiological parameters, are most important contributors to symptom severity in patients with refractory heartburn/regurgitation symptoms. Psychological processes, both general and symptom-specific, should be considered as another important factor within the multifactorial processes that impact reflux symptom severity reporting, across the reflux spectrum. |
Salivary extracellular miRNAs for early detection and prognostication of esophageal cancer: a clinical study. The salivary EVP-based 6-miRNA signature can serve as noninvasive biomarkers for early detection and risk stratification of ESCC. Chinese Clinical Trial Registry, ChiCTR2000031507. |
Surveillance for Presumed BD-IPMN of the Pancreas: Stability, Size, and Age Identify Targets for Discontinuation. The risk of developing pancreatic malignancy in presumed BD-IPMN without WF or HRS after 5 years of surveillance is comparable to that of the general population depending on cyst size and patient age. Surveillance discontinuation could be justified after 5 years of stability in patients older than 75 years with cysts < 30 mm, and in patients 65 years or older who have cysts = 15 mm. |
| Gastrointest Endosc |
Artificial intelligence for evaluating the risk of gastric cancer: reliable detection and scoring of intestinal metaplasia with deep learning algorithms. Our findings suggested that this AI system would contribute to evaluating the risk of gastric cancer accuracy, reliability, and repeatability with worldwide standardization. |
CLINICAL OUTCOMES AND LEARNING CURVE FOR ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY DURING ADVANCED ENDOSCOPY TRAINING: A COMPARISON OF SUPINE VERSUS PRONE POSITIONING. Shorter procedure and room turnover times, and a comparable cannulation rate were found for supine vs prone ERCP. |
Endoscopic full-thickness resection versus endoscopic submucosal dissection for challenging colorectal lesions: a randomized trial. EFTR is comparable to ESD in the treatment of challenging colorectal lesions in terms of safety and efficacy. EFTR is considerably faster than ESD in the treatment of non-lifting lesions and adenoma recurrences. |
EUS-GUIDED GALLBLADDER DRAINAGE USING A LUMEN-APPOSING METAL STENT AS RESCUE TREATMENT FOR MALIGNANT DISTAL BILIARY OBSTRUCTION: A LARGE MULTICENTER EXPERIENCE. Our study shows that EUS-GBD with LAMS used as a rescue treatment for patients affected by malignant distal biliary obstruction represents a valuable option in terms of technical and clinical success rates, with an acceptable AEs rate. To the best of our knowledge, this is the largest study concerning the use of this procedure. (Clinical trial registration |
Face and content validity of a biological papilla designed for the Boškoski-Costamagna ERCP simulator. Our results demonstrate good face validity and excellent content validity of this biological papilla combined with the Boškoski-Costamagna ERCP Trainer. This new tool provides a useful, inexpensive, versatile, and easy tool to train sphincterotomy, precut, and papillectomy. Future studies should explore whether including this model in real-life training improves the learning curve of endoscopy trainees. |
Harnessing Language Models for Streamlined Post-Colonoscopy Patient Management: A Novel Approach. Results suggest that ChatGPT could aid healthcare providers in making informed decisions and improve adherence to post-colonoscopy surveillance guidelines. Future research should investigate integrating ChatGPT into electronic health record systems and evaluating its effectiveness in different healthcare settings and populations. |
Magnifying image-enhanced endoscopy-only mode boosted early cancer diagnostic efficiency: A multicenter randomized controlled trial. The o-MIEE mode resulted in a significant improvement in early upper gastrointestinal (UGI) cancer and precancerous lesions diagnosing; thus, it could be used for opportunistic screening. |
Utility of bilateral intraductal plastic stent for malignant hilar biliary obstruction compared with bilateral self-expandable metallic stent: A propensity score-matched cohort analysis. Bilateral IS placement can reduce the duration of the endoscopic procedure, provide sufficient stent patency both initially and after ERI stent placement, and is removable. Bilateral IS placement is considered a good option for initial UHMBO drainage. |
| Gut |
Multivalent tyrosine kinase inhibition promotes T cell recruitment to immune-desert gastric cancers by restricting epithelial-mesenchymal transition via tumour-intrinsic IFN- Our findings identified potential druggable targets relevant to patient groups, especially for refractory immune desert-type/ 'cold' GC. Dovitinib, an RTK inhibitor, sensitised desert-type immune-cold GC to CTLA4 blockade by restricting EMT and recruiting T cells. |
| Hepatology |
Adequate vs. deep response to UDCA in PBC: To what extent and under what conditions is normal ALP level associated with complication-free survival gain? PBC patients with an adequate response to UDCA and persistent ALP elevation between 1.1 and 1.5 xULN, particularly those with advanced fibrosis and/or who are sufficiently young, remain at risk of poor outcome. Further therapeutic efforts should be considered for these patients. |
GRP/GRPR enhances alcohol-associated liver injury via the IRF1-mediated Caspase-1 inflammasome and NOX2-dependent ROS pathway. A knockout or antagonist of GRPR during excess alcohol intake could have anti-inflammatory and antioxidative roles, as well as provide a platform for histone modification-based therapy for ALI. |
Hepatocellular carcinoma surveillance may be associated with potential psychological harms of in patients with cirrhosis. Psychological harms of HCC surveillance appear mild but differ by test result. Future research should determine the impact of psychological harms on value of HCC surveillance programs. Clinical trials number NCT02582918 and NCT03756051. |
Indolent cancer and pattern of progression: Two missing parameters in trial design for hepatology. Moreover, we discuss the related-causes that explain the indolent profile of HCC and propose (a) refining the progression-related end-point by the pattern of progression to minimize the limitations of the current end-points; (b) considering alternative statistical tools for survival analysis such as Milestone Survival, or Restricted Mean Survival Time to capture the value of indolent HCC. According to these considerations, we propose incorporating novel end-points into the single arm of phase I/II CT as exploratory analysis or as a secondary end-point in phase III CT. |
Seladelpar efficacy and safety at 3 months in patients with primary biliary cholangitis: ENHANCE, a phase 3, randomized, placebo-controlled study. Patients with primary biliary cholangitis (PBC) with inadequate response or intolerance to UDCA who were treated with seladelpar 10 mg had significant improvements in liver biochemistry and pruritus. Seladelpar appeared safe and well tolerated. |
| Neurogastroenterol Motil |
Adult-onset megacolon with focal hypoganglionosis: A detailed phenotyping and prospective cohort study. Adult-onset megacolon with focal hypoganglionosis has distinct features characterized by hypoganglionosis due to inflammation. Bowel resection appears to benefit these patients. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
Review article: Translating STRIDE-II into clinical reality - Opportunities and challenges. Prospective studies, objective criteria for risk stratification, and better predictors of therapeutic response are needed to potentially render 'treating to target' more effective in the future. |
| Gastroenterology |
| Gut |
Drug rediscovery in gastroenterology: from off-label to on-label use of thioguanine in inflammatory bowel disease. In this paper, we aim to visualise potential hurdles that hamper drug rediscovery in general, emphasise the global need for optimal use and development of potentially useful drugs, and provide an overview of the registration process for TG in the Netherlands. With this summary, we aim to guide drug rediscovery trajectories in the near future. |
| J Hepatol |
Gilbert´s syndrome revisited. However, since the re-discovery of the potent antioxidant effects of bilirubin in the late 1980s, as well as multiple intracellular signaling pathways affected by bilirubin, an ever-increasing body of evidence suggests that subjects with Gilbert´s syndrome may benefit from the mild hyperbilirubinemia and are virtually protected from the development of a wide variety of "diseases of civilization" such as cardiovascular diseases, certain cancers, autoimmune or neurodegenerative diseases. This review analyzes the current state of medical knowledge given recent discoveries in this rapidly developing field, as well as their possible clinical significance, and gives a new perspective to this condition. |
| Neurogastroenterol Motil |
Prescription pain medications for disorders of gut-brain interaction: Comparing usage patterns with clinical practice recommendations. In the retrospective study published in this journal, Luo et al examine the use of prescription pain medications from a global perspective among patients with DGBI using the Rome Foundation Global Epidemiology Study. This review article provides an overview of usage patterns of various pharmacologic pain management agents (opioids, central neuromodulators, antispasmodics, and other peripherally acting agents) and non-pharmacologic therapies in the context of clinical practice recommendations on the management of DGBI pain. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
| Clin Gastroenterol Hepatol |
| Endoscopy |
| Gastroenterology |
| Gastrointest Endosc |
Letters to the editors and authors’ replies
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| J Hepatol |